脑卒中患者与照顾者自我护理体验的Meta整合

Experience of stroke survivors and caregivers on self-care:a Meta-synthesis of qualitative research

目的系统评价脑卒中患者与照顾者对自我护理体验的质性研究,为更好地制订与改进脑卒中自我护理干预方案,促进患者与照顾者身心健康提供参考依据。方法计算机检索PubMed、Web of Science、Embase、PsycINFO、CINAHL、Cochrane Library、澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健数据库、中国知网和万方数据库等中英文数据库,筛选关于脑卒中患者/照顾者和自我护理相关的质性研究,检索时限为建库至2021年6月。采用JBI循证卫生保健中心质性研究质量评价工具对纳入文献进行方法学的质量评价,运用汇集性Meta整合方法整合结果。结果共纳入12篇研究,提炼出46个明确的研究结果,将相似的研究结果归纳形成11个新类别,综合出3个整合结果:脑卒中患者和照顾者对自我护理概念、意义与影响因素的理解;脑卒中患者与照顾者对自我护理相关技能与策略的看法;脑卒中患者与照顾者对自我护理支持可接受性与可持续性的观点。结论脑卒中患者与照顾者对自我护理的看法和期望十分重要,未来可开展脑卒中患者与照顾者二元自我护理支持项目,并适当借助数字化技术和平台的优势,丰富自我护理干预形式和内容,形成更具针对性的自我护理干预方案。

Objective To systematically evaluate the qualitative research about experience of patients and caregivers on self-care,so as to provide references for better developing and improving stroke self-care intervention programs and promoting physical and mental health of stroke survivors and caregivers.Methods PubMed,Web of Science,Embase,PsycINFO,CINAHL,Cochrane Library,Joanna Briggs Institute(JBI),CNKI,Wanfang database and other Chinese and English databases were searched by computer to screen qualitative studies related to stroke survivors/caregivers and self-care.The retrieval time was from the establishment of the databases to June 2021.Joanna Briggs Institute evidence-based health care center quality evaluation tool was used to evaluate the methodological quality of the included literature,and the results were integrated by meta-integration method.Results A total of 12 studies were included,and 46 clear research results were extracted.The similar research results were summarized into 11 new categories,and 3 integrated results were synthesized:understanding of the concept,significance and influencing factors of self-care by stroke survivors and caregivers;perceptions of stroke survivors and caregivers on skills and strategies related to self-care;views of stroke survivors and caregivers on the acceptability and sustainability of self-care support.Conclusion Views and expectations of stroke survivors and caregivers on self-care are important.In the future,dyadic self-care support programs for stroke survivors and caregivers can be carried out,and the advantages of digital technology and platforms can be used to enrich the forms and contents of self-care interventions and form more targeted self-care interventions.